Device and method for fixing, compressing or shaping (parts) of the body

ABSTRACT

The invention relates to a device and method for fixing, compressing or shaping a body, or parts of the body, in particular the human body. The inventive device has a bearing surface ( 1 ) for the body, and at least one external element ( 2 ) which can be freely positioned on the bearing surface ( 1 ). The external element ( 2 ) and the bearing surface ( 1 ) together form a low-pressure chamber ( 6 ) which surrounds the body. The device also has at least one suction opening ( 3 ) which is connected to the low-pressure chamber ( 6 ).

This patent application claims priority under 35 U.S.C. §365 fromInternational Application No. PCT/EP98/04501, filed Jul. 20, 1998, whichclaims priority from German Application No. 197 31 040.0, filed Jul. 19,1997, said application being incorporated herein by reference for allpurposes.

This invention relates to an apparatus and a method for fixingbodies/body parts, especially of the human body or human body parts.

In many fields of human medicine or medical research and technologysecure fixing of the patient or a person under investigation isnecessary. This is of greatest importance especially in the field ofdiagnostic use (radiology), radiotherapy or in operative/surgicalinterventions (neurosurgery, ENT, etc.) but also during (acute orpermanent) pre- or post-operative care of wounds/injuries. Therequirements on accuracy and reproducibility, both in determining astereo-tactical frame system in or on the human body and also in fixingthe body itself, have been increased by the introduction of computertechnology in diagnosis and therapy.

The following fixing methods are known as the state of the art:

a) fixing the body with adhesive tapes or cuffs: The body of the patientlies on a foam material pad. Tapes tensioned transversely over the bodyfix the patient on this pad. The following points are disadvantageous:

indentation, pressure points, displacements and/or swelling of the skincan arise from the strong pull of the adhesive tapes;

after removal of the retaining elements (adhesive tapes) it is hardlypossible to effect repositioning in exactly the same position again,which is a disadvantage particularly in stereo-tactical operations andin radiotherapy;

the body cannot be fixed adequately; movement in the sideways directionin particular (laterally) cannot be restricted or defined adequately.

b) fixing the body by screwing into the bone: The body of the patient isscrewed to a metal frame at various places. The following aredisadvantages:

screwing to the bone is an invasive procedure and is thus only possibleand justified for particular indications;

the physical stress on the patient is substantial;

the method can only be used for specific positions of the patient andimpedes the operator;

fixing of the soft parts (muscles, ligaments, connective tissue) ishardly possible at all.

c) fixing by formworks: The patient is placed on a kind of “airmattress”, which is filled with foam material balls. By sucking the airout of this mattress, this becomes solid through the foam material ballslying against one another. The vacuum mattress is thus matched to thebody in the first step and is sucked out in the second step. Animpression of the body is obtained by this method. Disadvantages in thisare:

the “mattresses” usually employed do guarantee immobilisation but notfixing with uncooperative or anaesthetised patients adequateimmobilisation is hardly possible at all;

an inadequate impression of the patient often results, since themattress can hardly bear exactly on all body parts;

pressure points often result from formation of folds or too strongpressure, which can lead to pressure points and damage to tissues,especially with anaesthetised patients.

Other moulding materials, such as rails, thermoplastic material orplastics moulds, gypsum, etc. exhibit similar disadvantages. Inaddition, these methods involve substantial expenditure in money or timeand are therefore only used for long-term applications.

The invention is therefore based on the object of providing an apparatusand a method for fixing/making moulds/compressing the human body or bodyparts, which avoids the cited disadvantages, is of simple structure andsimple to use and kind to the patient to a high degree. The apparatusshould moreover facilitate the exact application of calibration points(so-called markers) and optimal accessibility to operation regions.

This object is met by an apparatus according to the features describedwith reference to the present invention and the associated method.

In contrast to the apparatuses and procedures initially described, thefixing of the human body is effected in the proposed apparatus or methodessentially by vacuum force. A blanket-like outer element is placed overa body support surface (flexible or rigid) with suction openings and issucked at least substantially airtight on to the body support surface inits edge region projecting beyond the body (of the patient) A closedvacuum chamber thus results, so that the body is fixed relative to thesupport surface exactly and immovably in all directions.

The patient simply lies on the body support surface in the preferredarrangement and is “covered up” with the ox-like outer element. Thepatient or his body part(s) is/are now surrounded by this bag-likestructure. Parts of the body (arms, legs, head, back) can emerge fromthe air or vacuum chamber through “peepholes” and thus remain unfixed,these openings being bounded by airtight arrangements, e.g. rubber bandsor airtight cuffs. The air is now sucked out of the space between thebody support surface and the outer element and the patient is fixed inthe vacuum chamber thus resulting.

The described outer element or the body support surface is formed in thepreferred embodiment from structurally reinforced, easily stretchedplastics material or a metal foil and can accordingly adapt accuratelyto the anatomical structure of the body. By suitable choice of thematerial thickness and/or the level of the vacuum in the vacuum chamberan enhanced fixing or even compression of the body (of the patient) canbe realised, so that the foil-like outer element lies like a second skintaut over the body (part).

By virtue of this fixing by means of vacuum it can be ensured thatfixation which is always firm, exact and remaining constant is madepossible, in particular after repeated use of the apparatus.

Vacuum pumps with adjustable degree of suction, hose connections andshut-off valves can be used as means for creating a vacuum. Thesedevices can also be controlled/regulated in their vacuum action. Inorder to assist the vacuum action, shallow hollow spaces or vacuumchannels can be formed by the creation of pores/channels on the outerelement or the body support surface, which ensure uniform sucking out,for example by means of an air-bubble film with bumps known forprotective packing. The previously described closed system can therebyalso be operated as a semi-open system with constant sucking out of air,especially to facilitate the skin breathing during long operations. Afurther method of achieving the described effect is to overlay and/orunderlay between the outer element and the patient with anet/fleece/foam material or similarly structured material. Suchmaterials ensure optimal flow of the air in all body regions, throughthe number of their air channels/pores in this application. Other mediathan air can also be used to create the vacuum. Possible “air-flowbarriers” which are created by the suction or affect this are thusprevented. Pressure measuring devices serve to control a comparativelyconstant pressure on the body regions.

With a safety button the patient himself (e.g. in case of sickness orpanic) or the operator (e.g. in case of complications during theintervention) can interrupt the vacuum (or even convert the vacuumbriefly into a raised pressure) and thus release the body of the patientfrom the fixing very rapidly and without complication, since the outerelement is then lifted “at a stroke” from the support surface.

The blanket-like outer element, preferably in the form of a heatprotective aluminium foil known per se, can be packed sterilely as adisposable article but is also easy to clean and sterilise, so that theoperating costs remain small, since all essential parts can be reused.

In addition to the pure fixation/compression/making moulds, auxiliaryapparatuses (such as guide devices, optical apparatus, target devices,etc.) can be fitted by means of mechanical/pneumatic or magneticanchorage, since the blanket-like outer element takes up hardly anyadditional space. Reproducible application with high accuracy istherefore possible through scaling or similar devices.

The body (part) can be so placed that practically any body region iscompletely accessible to the treating doctor or other treating person,especially for surgical interventions, while such an aluminum orplastics foil can be opened with a scalpel after application of thevacuum, without a pressure drop. An auxiliary fixing for additionalsecuring of the patient constructed like the blanket-like outer elementand thus capable of variable positioning is particularly advantageous.Above all in soft regions of the upper or lower abdomen or in theshoulder region, the fixing action can be enhanced by simple applicationof splint and support elements. The application of these splintsadditionally increases the repositioning accuracy. Likewise fixing ofthe patient, especially in the case of restless patients or of largeapplications of force from the outside, as in procedures with bones orcartilages, is ensured by this.

In addition this vacuum technique with at least one outer element lyingon the body or the skin facilitates particularly uniform pressuredistribution and thus relief of the patient. Injuries are practicallyruled out, even with anaesthetised patients, who cannot give anyindication of pain in case of pressure pain.

A particular advantage is also the application of passive or activecalibration points on the outer element or the support surface, whichdetermine reference points and reference planes in modern medicine inthe practical application of imaging methods such as CT (computertomography) or MRI (magnetic resonance imaging). The fixing apparatusthus allows calibration points to be applied to a part of the apparatus(primarily to the body support surface), which can be used as referencepoints for further measures, with or without fixing of the patient, suchas calibration for preparations for operations for example.

If the objective is not only fixation but also reproducible positioning,additional prefabricated formwork, bands, vacuum mattresses can be used,which enhance the reproducibility. Since the body of (the patient)“wanders” during the sucking out into the same position, especially withconcave support surfaces, a high accuracy of repositioning can beestablished. The resistance between the patient and the formwork orbetween the patient and the outer element or body support surface can bekept particularly small by slip films, so that assumption of the correctposition is effected by shear forces, without high expenditure of force.

Cushioning underneath further increases the comfort. By variable vacuumregulation the cushioning action can be partially removed by increasingthe vacuum and the fixation be enhanced and vice versa, A differentvacuum can be applied for different body regions or it can be variedduring the course of a fixation, for example in order to exert amassaging effect to increase the blood flow.

The outer element can either by closed pressure tight, as is the casewith an aluminium foil, or have fine pores/channels, whereby the desiredvacuum can be maintained correctly by a permanent “flow”, The airflowing in can be regulated in heat and moisture content, in order toachieve a desired cooling/heating or drying/moistening of the fixedbody. It is also possible as a supplement to or instead of the inflowingair to use other gases or fluids, which accelerate the healing processof wounds for example. It is thus also possible to create an artificialclimate under the sucked on outer element and in the vacuum chamber thusformed.

The described fix can either be used for the whole body or equally forindividual body parts only. Thus broken bones for example and complexfractures can be immobilised by means of the described vacuum fixation,instead of by gypsum bandages. In a preferred method, formwork orsplints with the anatomy to be achieved are incorporated in the vacuumbandage. The applied vacuum causes homogenous application of theformwork to the body parts or apply the body pans to these structures.With open wounds or major cut injuries, which result in a lot of scarformation, the vacuum bandage causes the wound edges to lie against oneanother and thus allows smooth surfaced closure. Thus a skin seam r atthe skin surface can be dispensed with in many cases.

A further application is homogenous application and pressing on ofmaterials and fabrics on to the skin surface of the patient. Thematerial or fabric in question is applied to the desired site. The outerelement is then laid on as the vacuum dressing. If the air is now suckedout, the applied material is necessarily applied to the skin surface.Instead of direct application to the skid surface the outer element canalso be applied on other kinds of fabric and structures.

Cut-outs in the outer element or in the body support surface, whichclose airtight on the patient through edge seals, allow direct, optimumaccess to the patient for the operator. This “operation window”,especially in the outer element, can be provided with an anatomicallyshaped, structure-giving element, depending on the body region, forexample with an edge-reinforced rubber band. The airtight closure isachieved either through the characteristic of the outer skin itself, forexample an inner rubberising, or through sealing materials (adhesives,rubber strips, etc.),

Preferred embodiments will be explained and described in more detail inthe following with reference to the drawings, in which:

FIG. 1 shows an apparatus for fixing the body of a patient in aschematic plan view;

FIG. 2 shows the apparatus according to FIG. 1 in side view;

FIG. 3 shows the apparatus according to FIGS. 1 and 2 in cross-section;

FIG. 4 shows a preferred application of calibration systems to thesupport surface, in plan view;

FIG. 5 shows a patient with a splint in cross-section;

FIG. 6 is a sectional view of moulding by the vacuum method;

FIG. 7 is a sectional view of a two-sided, flexible patient covering orblanket with a fame suspension;

FIG. 8 shows a vacuum dressing with splints in side view;

FIG. 9 is a comparative schematic drawing for illustrating afixation/making a mould (A) and a compression (B) of a body, incross-section;

FIG. 10 is a schematic drawing for showing the suction with individualsuction channels (A) and suction with a suction chamber (B), incross-section;

FIG. 11 shows a vacuum dressing with formwork in cross-section;

FIG. 12 is a schematic view of a guide device for formwork and splintelements; and

FIG. 13 shows an operation window in an outer element in cross-sectionand in plan view.

A preferred embodiment comprises a body support surface 1 made from alight material transparent to X-rays, to or from which further plateparts can be attached or removed in modular manner (ability to extend,reduce). Extruded, double web plastics plates of PMMA can be used assuch plates for example, as known from ceiling claddings for example.These hollow chamber plates form at the same time a suction chamber 16in their interior, shown at the right in FIG. 10, which is incommunication with a plurality of suction opening 3. The body supportsurface 1 is thus light and transportable. It can be attached at itssides to stable suspension devices 4, for example screw fittings, to anoperating table. The body support surface 1 can be adjusted and turnedat these attachments in the horizontal and vertical direction relativeto the operating table, a high degree of rigidity being ensured in eachposition.

A foil-like outer element 2 is placed on the body support surface 1serving as a reference base. Airtight zip fasteners, sticking, clampingand plug-in connections 9 serve in particular to fix the outer element 2at the surrounding edge region and can be operated simply and rapidlyand make a firm and tight closure against the external air possible. Itshould be noted that, with suitable choice of material, especially athin plastics or metal foil as the outer element 2, it is possible todispense with such fixing at the edge region, since such an outerelement 2 itself clings flat at the edge region of the body supportsurface 1 and thus effects a seal, especially with inner rubberisationor similar coating. The outer element 2 can however be made relativestable in form as a plastics part, like a lid or a convex shell, likethe (concave) body support surface 1, only then being applied to thebody of the patient (denoted P) when a vacuum is applied.

The outer element 2 is first laid loosely on the patient P in the mannerof a bedspread or a cloth and pressed down or fixed at the outer edgeregion of the body support surface. Then the medium (in particular air)in the vacuum chamber 6 thus formed (cf. FIG. 3) is sucked out throughsuction openings 3. The foil preferably used as the outer element 2 isincreasingly applied to the patient P by the suction. The vacuum in thevacuum chamber 6 can be controlled permanently through measuring probes,

Access openings 5 with cuffs in the outer element 2 make it possible forbody parts to emerge from the vacuum chamber 6, so that fixation/makinga mould/compression is avoided. Thus the respiratory tract and ears(eardrum inflation) can be freed from the applied vacuum.

The vacuum chamber 6 can form a system closed relative to thesurroundings in the simplest implementation. One-time evacuation andclosure of the system, for example by means of the shut-off valve 21shown in FIG. 10, allows the vacuum present in the vacuum chamber 6 tobe maintained constant for a long time. A further possibility however,especially for long operations, to make the system “half open” byprovision of pores or air channels 23. The desired vacuum in the vacuumchamber 6 can then be maintained by permanent suction (under “flow”) .Likewise de introduction of suitable media (cooling fluid, medicationnutrient solutions, etc.) is then possible. Also materials issuing fromthe body (blood, wound secretions, . . . ) can be sucked off inadvantageous manner. A further application would be the suction of fattytissue under the skin with post-operative maintenance of the vacuum as apressure dressing.

As shown in FIG. 3 in particular, the patient P preferably lies on asupport element 8, which is located between the patient P and the bodysupport surface 1. This air-permeable patient support 8 is maderelatively soft (e.g. fabric, fleece, pad, . . . ) and thus serves toenhance the comfort of lying, but can also be a solid,structure-imparting mould (e.g. a tray, concave cushion, etc.) and thusmake reproducible positioning possible for multiple interventions.Similar insert elements 7, like the support element 8 can also be fittedbetween the outer element 2 and the patient P. The insert and supportelements 7 and 8 can be freely movable and thus be adapted to the bodyof the patient P, or be fixed on the body support surface 1. Theyincrease the accuracy of repositioning and make the support surface onthe body support surface 1 larger.

An alternative to the flat body support surface 1 is offered by the useof a frame 15 shown in FIG. 7, in which two outer elements 2 are fixed,so that the body (or individual body parts) is completely enveloped bythe outer skin, the patient therefore being suspended freely in fixedstate in the frame 1S. The patient is completely surrounded by the outerelements 2 with this technology in the fixed state and, with aninextensible foil, practically the same pressure is exerted on all bodyparts in the fixed state. If on the other hand a rigid body supportsurface 1 or an outer element 2 which can only stretch moderately isused, the pressure on some body regions can be enhanced.

The body support surface 1 and the outer element 2 can also besubdivided by division into chambers. Independent pressure conditionscan then be created in the individual chambers. In additionsupplementary devices, such as freely positioned, stand-like supportelements or retaining devices 18/19 (cf. also FIG. 12) can be fittedmechanically, magnetically or pneumatically on the body support surface1.

With stereo-tactical operations reference points are further essential,where the previously described elements can also serve as holders forcalibration points 10. The calibration points shown in FIG. 4 in theform of lead balls can serve as a simple reference system. However othersensor types can also be used, e.g. optical reflectors, radioactive orinductive emitters. Calibration lines 11 extending transversely over thebody support surface 1 or the outer element 2 are also conceivable,allowing accurate conclusions as to the patient's position to be formedfrom their geometry. Such calibration systems or marker systems can thusbe applied to the body support surface 1, the outer element 2 or also onthe holding arms 19 or splints 12 or formwork 17 (cf. FIG. 12). The saidsplints 12 (e.g. strips or bands) can increase the fixing of the bodyregion involved (e.g. with soft parts), especially in operations onregions which are hard to fix.

As shown in FIG. 6 moulding materials 13 can be filled in through ashaping container 14 (closed or open) fitted over the outer element 2,especially PU foam, gypsum or styro porous balls, which then can befixed to make a body impression. Insert elements (strips, rubber mats)can be introduced in the moulding material 13. After hardening of themoulding material 13 individual insert elements can be pulled out andserve as vacuum channels within the outer element 2 individual to thepatient thus formed for later repositioning.

As shown in FIG. 10, the suction openings 3 can either lead directlyinto the vacuum chamber 6 or be connected to the vacuum chamber 6through a suction chamber 16. In the latter arrangement a plurality ofsuction openings 3 connected to the suction chamber 16 can be operateduniformly with exactly the same vacuum. Such a suction chamber 16 or thedescribed suction openings 3 (especially fine perforations in the upperwall of the body support surface 1) are present not necessarily only inthe body support surface 1 but can also be fitted or integrated into theouter element 2.

The practical use of the proposed apparatus will be described asfollows.

a) for (pure) fixation:

for immobilisation during diagnostic procedures (CT, MRI);

during operations, taking biopsies, irradiation, etc.;

to immobilise patients, e.g. for psychiatrically ill patients (“vacuumstraitjacket”) or to avoid injury of somnolent/comatose patients;

to immobilise body parts with (orthopaedic and surgical) injuries, withthe advantage of simultaneous sucking away of wound secretions and/orcompression of bleeding;

b) for compression:

shock treatment with various forms of shock;

care of amputations;

suppression of bleeding in injuries to blood vessels/amputations;

to simulate artificial pressure conditions (e.g. for training astronautsor divers);

post-operative treatment (compression dressing, e.g. also for tattooing,application of cooling media);

c) for making moulds of body parts:

exact application of moulding elements and masses (e.g. as PU foam);

d) for reproducible fixation:

for repeated interventions, in which the same patient positioning isalways necessary (especially all stereo-tactical uses: e.g.neuro-surgery, brachy-therapy, fractionated irradiation).

The advantages can be summarised as follows:

a) for fixation:

uniform compression of the body (if desired);

maximum visibility and freedom of movement for the operator;

positioning of the body in variable positions during interventions;

no displacement of the skin or shifts in position are possible;

ability to introduce instruments, (e.g. an endoscope);

b) for reproducible fixation:

definition of exact calibration points for stereo-tactical interventions(optical, radioactive or inductive sensors or emitters, etc.) in alwaysthe same relation to the body;

small material outlay;

c) for making moulds:

no fold formation in the foil outer element;

highest accuracy through exact application by means of a vacuum;

d) general advantages:

highest stability with small weight;

suitability for diagnostic methods (CT, MRI);

uniform pressure at all points or enhanced pressure at places withfitted splint elements;

continuous pressure regulation is possible;

space-saving construction;

simple and time-saving handling through the vacuum application andtherefore particularly kind to the patient and hygienic;

high patient safety through control of the vacuum in the vacuum chambersand the pressure loading of the patient;

in addition the possibility of immediate release and non-invasivefixing.

What is claimed is:
 1. A low pressure chamber for surrounding at least aportion of a body comprising: a body support surface; at least one outerelement, which can be positioned freely on the body support surface andforms with the body support surface a vacuum chamber surrounding the atleast one portion of the body; at least one suction opening, whichcommunicates with the vacuum chamber; and wherein the body supportsurface is formed elastically in a supporting direction.
 2. A lowpressure chamber as recited in claim 1, wherein the body support surfacecan be connected in an airtight manner to the outer element.
 3. A lowpressure chamber as recited in claim 1, wherein the outer element is offlexible, especially foil-like form.
 4. A low pressure chamber asrecited in claim 1, wherein the outer element is elastic in an applieddirection and is inextensible in a transverse direction.
 5. A lowpressure chamber as recited in claim 1, wherein the body support surfaceis fittable to a table by means of a pivot suspension.
 6. A low pressurechamber as recited in claim 1, wherein the outer element is so formedthat it can be sucked onto an edge region of the body support surface.7. A low pressure chamber as recited in claim 6, wherein the outerelement is additionally fixable to the edge region of the body supportsurface at least one of mechanically, pneumatically and magnetically. 8.A low pressure chamber as recited in claim 6, further comprising fixingsfitted to the edge region of the body support surface.
 9. A low pressurechamber as recited in claim 1, wherein additional devices can be fittedon the body support surface at least one of mechanically, pneumaticallyand magnetically, said devices being capable of being repositioned. 10.A low pressure chamber as recited in claim 1, wherein the at least onesuction opening is connected to at least one common suction chamber. 11.A low pressure chamber as recited in claim 10, wherein the at least onesuction chamber is provided in at least one of the body support surfaceand the outer element.
 12. A low pressure chamber as recited in claim 1,wherein the body support surface is divided into individual suctionchambers.
 13. A low pressure chamber as recited in claim 12 wherein theouter element is partially permeable to air by means of at least one ofpores and flow channels.
 14. A low pressure chamber as recited in claim1, wherein the outer element is divided into individual vacuum chambers.15. A low pressure chamber as recited in claim 12, wherein the outerelement effects complete airtight closure.
 16. A low pressure chamber asrecited in claim 15, wherein at least one of the suction openings andsuction chambers is closeable by means of a shut-off valve.
 17. A lowpressure chamber as recited in claim 1, wherein at least one of the bodysupport surface and the outer element consists of individual modulesjoinable together.
 18. A low pressure chamber as recited in claim 1,wherein the outer element is substantially similar in material andstructure to the body support surface.
 19. A low pressure chamber asrecited in claim 1, wherein insert elements are fittable between a bodyand at least one of the outer element and the body support surface. 20.A low pressure chamber as recited in claim 19, wherein the insertelements are formed as at least one of splints and formwork in at leastone of the outer element and the body support surface.
 21. A lowpressure chamber as recited in claim 1, further comprising preformedpatient supports applied to at least one of the body support surface andthe outer element.
 22. A low pressure chamber as recited in claim 21,wherein the patient supports further comprise slip films.
 23. A lowpressure chamber as recited in claim 22, wherein the patient supportsfurther comprise rubber mats.
 24. A low pressure chamber as recited inclaim 1, further comprising a moulding container for reception of amoulding material applied to the outer element.
 25. A low pressurechamber as recited in claim 1, wherein the body support surface and theouter element further comprise at least one of a material permeable toX-rays and a non-ferromagnetic material.
 26. A low pressure chamber asrecited in claim 1, further comprising at least one of markings and pegbores on the body support surface for repositioning a patient.
 27. A lowpressure chamber as recited in claim 1, further comprising stretch-overdevices on the body support surface.
 28. A low pressure chamber asrecited in claim 1, further comprising holding elements including atleast one o magnetic and pneumatic holders, fitted to the body supportsurface for receiving medical apparatus comprising at least one ofendoscopic apparatus, wound retractors, hand support surfaces andstereo-tactical navigational aids.
 29. A low pressure chamber as recitedin claim 1, further comprising fixation devices attachable to the bodysupport surface.
 30. A low pressure chamber as recited in claim 1,further comprising pressure measuring devices for controlling a pressuredistribution in the vacuum chamber.
 31. A low pressure chamber asrecited in claim 1, further comprising a patient release mechanismoperable to abruptly remove the vacuum in the vacuum chamber.
 32. A lowpressure chamber as recited in claim 1, wherein at least one of theouter element and the body support surface further comprises at leastone access opening, the at least one access opening being sealed offaround itself.
 33. A low pressure chamber as recited in claim 1, furthercomprising operation openings which are sealed around and formed in atleast one of the outer element and the body support surface.
 34. A lowpressure chamber as recited in claim 1, further comprising at least oneadjustable calibration system formed in at least one of the body supportsurface and outer element for establishing a position of a plurality ofreference points.
 35. A low pressure chamber as recited in claim 1,wherein the outer element and the body support surface form a unit, theunit being formed in surrounding relationship to the at least oneportion of the body like a bag.
 36. A low pressure chamber as recited inclaim 1, wherein the body support surface and the outer element arestretched in a frame suspension.
 37. A low pressure chamber as recitedin claim 1, wherein the body support surface and outer element furthercomprise an initially flexible material which hardens irreversibly, thematerial including a thermo-moulding material.
 38. A low pressurechamber as recited in claim 1, wherein the at least one suction openingis formed as at least one individual suction channel.
 39. A low pressurechamber as recited in claim 38, wherein the at least one individualsuction channel is closeable by mean of a shut-off valve.
 40. A lowpressure chamber as recited in claim 1, wherein the outer element issubstantially the same in material and structure to the body supportsurface.
 41. A low pressure chamber as recited in claim 1, furthercomprising individually formed patient supports applied to at least oneof the body support surface and the outer element.
 42. A low pressurechamber as recited in claim 1, further comprising expansion devicesdisposed on the body support surface.
 43. A low pressure chamber asrecited in claim 1, further comprising compaction devices disposed onthe body support surface.